H.R. 4611: EACH Act of 2025
Sponsor
Ayanna Pressley
Democrat · MA-7
Bill Progress
Latest Action · Dec 19, 2025
Assigned to Subcommittee on Health. for review
Federal health plans would have to cover abortion
Why it matters
For nearly 50 years, a federal ban has kept programs like Medicaid from paying for most abortions. H.R. 4611 would flip that rule across almost every federal health system — Medicaid, Medicare, TRICARE, VA care, the Indian Health Service, and federal employee plans — turning abortion from an excluded benefit into a required one. It has 185 cosponsors, all Democrats.
H.R. 4611, the EACH Act, would require abortion coverage across a long list of federal and federally connected health programs. That includes Medicaid, CHIP, Medicare, TRICARE, the Indian Health Service, federal employee health benefits, veterans' care, the Peace Corps, and systems that serve people in immigration custody or refugee programs.
The coverage rule is broad. The bill defines abortion services to include the abortion itself plus any related care provided alongside it, even when that care happens on a different day.
It reaches past insurance, too. The bill says the federal government, acting as a health care provider, must ensure access to abortion services for people eligible for care in its own facilities or ones it contracts with.
H.R. 4611 would also repeal the Affordable Care Act provision that has governed how abortion coverage works in certain marketplace plans, and it bars federal officials from blocking abortion coverage offered by states or private insurers.
To make all of that stick, the bill says it would override conflicting federal law and would not be subject to the Religious Freedom Restoration Act. It also keeps any state or federal law with stronger abortion-coverage protections in place.
H.R. 4611 Bill Summary
What H.R. 4611 actually does.
Abortion becomes a required benefit in federal health plans
Every program on the bill's list — Medicaid, CHIP, Medicare, Medicare supplemental plans, TRICARE, the Indian Health Service, veterans' care, the Federal Employees Health Benefits Program, the Peace Corps, and more — would have to cover abortion services for the people it insures.
Coverage includes related care, not just the procedure
The bill defines abortion services to include the abortion itself and any care provided alongside it, even when that related care happens at a different time or on a different day.
Federal facilities would have to provide access, not just pay for it
Beyond insurance, the bill says the federal government, in its role as a health care provider, must ensure access to abortion services for people eligible for care in its own facilities or ones it contracts with.
The ACA's abortion-coverage rules would be repealed
H.R. 4611 repeals Section 1303 of the Affordable Care Act, which has governed how marketplace plans handle abortion coverage, and replaces it with a broader federal coverage requirement.
Washington could not block state or private coverage
The bill says the federal government may not prohibit, restrict, or inhibit abortion coverage offered by state or local governments or by private health plans.
The bill would override conflicting federal law and RFRA
H.R. 4611 states that it supersedes other federal law and is not subject to the Religious Freedom Restoration Act. A severability clause keeps the rest of the act in force if any part is struck down.
Who benefits from H.R. 4611?
People on Medicaid, CHIP, and Medicare
The bill's findings note that women make up 54 percent of Medicaid enrollees and that about a quarter of Medicaid patients seeking an abortion end up carrying to term because they can't afford care out of pocket. For them, abortion would become a covered benefit instead of a cost they pay themselves.
Service members, military families, veterans, and federal workers
TRICARE enrollees, veterans, some surviving family members, and people in the Federal Employees Health Benefits Program would gain coverage that current law restricts to narrow exceptions like rape, incest, or a threat to the patient's life.
American Indians and Alaska Natives in the Indian Health Service
The bill's findings say the Indian Health Service, which serves roughly 2.56 million people, has been barred from providing abortions except in very limited cases since 1988. H.R. 4611 would lift that restriction for the program.
People in immigration or federal custody and refugee programs
The bill reaches people held by the Department of Homeland Security or Department of Justice, children in refugee resettlement care, and refugees receiving federally funded medical assistance — groups with few other coverage options.
Who is affected by H.R. 4611?
Federal agencies that run health programs
Agencies overseeing Medicare, Medicaid, TRICARE, the Indian Health Service, veterans' care, refugee care, and federal employee coverage would have to rewrite benefit rules and implementation guidance to add abortion services.
Insurers, plan administrators, and federal contractors
Private carriers and contractors that serve federal programs would need to update coverage, claims, and network policies to include abortion services as the bill defines them.
Groups that support the existing federal abortion-funding limits
The bill would displace federal restrictions like the Hyde-era funding ban where it applies, and it says religious-liberty challenges under RFRA would not govern the law — provisions opponents are likely to contest in court.
States that limit abortion coverage
The bill's findings say 25 states bar abortion coverage in ACA marketplace plans and 10 bar it in private plans. H.R. 4611 says the federal government could not block state or private coverage and that conflicting federal law would give way.
HR4611 Legislative Journey
House: Committee Action
Dec 19, 2025
Referred to the Subcommittee on Health.
House: Committee Action
Jul 22, 2025
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Natural Resources, Armed Services, Veterans' Affairs, the Judiciary, Oversight and Government Reform, and Foreign Affairs, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced
Jul 21, 2025
Introduced in House
+2 more actions this day
About the Sponsor
Ayanna Pressley
Democrat, Massachusetts's 7th congressional district · 7 years in Congress
Committees: Financial Services, Oversight and Government Reform
View full profile →
Cosponsors (185)
All 185 cosponsors are Democrats. Cosponsors represent 37 states: Alabama, Arizona, California, and 34 more.
Diana DeGette
Democrat · CO
Maxwell Frost
Democrat · FL
Janice Schakowsky
Democrat · IL
Alma Adams
Democrat · NC
Pete Aguilar
Democrat · CA
Gabe Amo
Democrat · RI
Yassamin Ansari
Democrat · AZ
Jake Auchincloss
Democrat · MA
Becca Balint
Democrat · VT
Nanette Barragán
Democrat · CA
Joyce Beatty
Democrat · OH
Wesley Bell
Democrat · MO
Cosponsor Coverage Map
Committee Sponsors
Veterans' Affairs Committee
10 of 25 committee members cosponsored
Foreign Affairs Committee
23 of 53 committee members cosponsored
Oversight and Government Reform Committee
19 of 47 committee members cosponsored
Judiciary Committee
18 of 44 committee members cosponsored
Armed Services Committee
24 of 57 committee members cosponsored
Natural Resources Committee
16 of 45 committee members cosponsored
Ways and Means Committee
14 of 45 committee members cosponsored
Energy and Commerce Committee
23 of 54 committee members cosponsored
17 Democrats across these committees haven't cosponsored yet. Mobilize their constituents
What laws does H.R. 4611 change?
2 changes
Sections Amended
Section 1303 of Patient Protection and Affordable Care Act (42 U.S.C. 18023) is repealed. (b) Conforming Amendments.-- (1) Basic health plans.--Section 1331(d) of the Patient Protection and Affordable Care Act (42 U.S.C. 18051(d))
striking paragraph (4)
Sections Repealed
1303 of Patient Protection and Affordable Care Act (42 U.S.C. 18023)
H.R. 4611 Quick Facts
- Committee
- Veterans' Affairs
- Chamber
- House
- Policy
- Health
- Introduced
- Jul 22, 2025
Assigned to Subcommittee on Health. for review
Dec 19, 2025
Official Sources
Official legislative page for the EACH Act of 2025, including status, text, sponsors, and actions.
Medicaid is the headline program the bill targets; this is the U.S. Code text of the federal-state medical assistance program whose coverage rules the bill would change.
H.R. 4611 would repeal Section 1303 of the Affordable Care Act; this is the current U.S. Code text of that provision governing abortion coverage in marketplace plans.
The bill states it would not be subject to RFRA; this is the U.S. Code text of the law the bill would set aside for its coverage requirement.
TRICARE is specifically included in the bill, and this official Defense Health Agency page explains covered health services under the military health program.
The bill would apply to veterans' care, making the VA's official health care portal a relevant source for how that federal system operates.
The Indian Health Service is one of the federal care systems listed in the bill as subject to its abortion coverage mandate.
H.R. 4611 Common Questions
Would H.R. 4611 make Medicaid and Medicare cover abortion?
Yes. Medicaid, Medicare, and the other federal programs on the bill's list would have to cover abortion services for the people they insure.
Would TRICARE, VA care, and federal employee plans be included?
Yes. TRICARE, veterans' health benefits, and the Federal Employees Health Benefits Program are all on the list of plans that would have to cover abortion services.
Does H.R. 4611 end the Hyde Amendment?
Effectively, yes. The bill overrides the federal restrictions that have blocked programs like Medicaid from paying for most abortions since 1976, requiring coverage instead.
What does the bill count as abortion services?
The abortion itself plus any care provided along with it — even if that related care happens at a different time or on a different day.
Would federal facilities have to provide abortions, not just pay for them?
Yes. Acting as a health care provider, the federal government would have to ensure access to abortion services for people eligible for care in its own facilities or ones it contracts with.
Could religious objections override the coverage requirement?
The bill says no. H.R. 4611 states that it is not subject to the Religious Freedom Restoration Act, the law often used to raise religious objections to federal mandates.
Does H.R. 4611 change the ACA's abortion-coverage rules?
Yes. It repeals Section 1303 of the Affordable Care Act, which has governed how marketplace plans handle abortion coverage, and replaces it with a broader federal requirement.
Where does H.R. 4611 stand, and could it pass?
It's in the House Subcommittee on Health with 185 cosponsors, all Democrats. Without Republican support it has no clear path in the current House, so it reads more as a marker for a future Congress.
Based on H.R. 4611 bill text
H.R. 4611 Bill Text
“To ensure affordable abortion coverage and care for every person, and for other purposes.”
Source: U.S. Government Publishing Office
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